Creative nonfiction writings and ruminations of a Family Physician. Much of this will be medical musing, patient and doctor stories, but I reserve the right to wander. Please feel free to add your comments and experiences!

Wednesday, September 16, 2009

In polite company we call it Novel H1N1. It’s the Influenza Formerly Known as Swine Flu. Originally thought to come from pigs, this flu virus is actually a mix of pig, bird and human. Believe it: only a virus could pull off that combination.

This rascal made a big splash last Spring, as you no doubt remember. After making its debut in the southern hemisphere it worked its way north, and by late summer there were so many cases the CDC stopped counting.

The media hype is hopping about this new germ, and lots of people are afraid. Since it is a new germ, and we haven’t been through a winter with it yet, there is a fair amount we don’t know. But what we do know is reassuring. Most of this comes from statistics but some comes from experience: we have already seen several cases here at Student Health and Counseling.

So far it looks like H1N1 is going to be gentler than the regular flu. Most cases of H1N1 are mild, and over with in a few days. Yes, there have been deaths around the country, but mostly in people who had serious medical problems. If you are otherwise healthy when you get the flu, you can put money on your survival.

Still, any flu can be miserable, so I suggest you don’t catch it. How to avoid it? Keep your hands off your face! That’s the best thing you can do. The flu enters your body through your respiratory system. That means through your mouth or your nose. How often do you pick your nose or your teeth? Don’t answer that. Just know that if the virus is on your hands when you touch your face, you’re toast.

Before I go further, I need to teach you a new word. Fomite, pronounced with a long O and a long I, accent on the Fo. Fomite is a medical term that means any object that can carry germs and pass them along. Fomites are things like towels, drinking glasses, pens, money. Here’s why this word matters.

The H1N1 flu is passed in large droplets. That means if a flu patient coughs, the virus flies out of their mouth in droplets. The droplets then fall onto the nearest surface. H1N1 doesn’t hang around in the air for long, unlike some other viruses that are passed in smaller, lighter droplets. How do you catch the flu then? Either you were unlucky enough to be in the line of fire when that person coughed, or – and here’s where that new word comes in – you touched a germy fomite and then touched your own face.

Think about it. Our hands are everywhere. We use them for everything. Opening doors, using a phone, handling money. As soon as you touch a fomite, your hands are host to whatever little nasties got on there from the other people who touched it. Then you wipe your nose or rub your eyes and wham. Germ transfer.

Yes, it is important to wash your hands, especially before you eat or otherwise touch your face, but washing your hands isn’t enough. The germs don’t soak in through your hands to make you sick, after all. So wash and sanitize, by all means, but mostly keep your hands off your face. If you have to touch your face, like to eat or put on makeup, wash your hands thoroughly first.

Besides washing your hands and keeping them off your face, take good care of your body in the usual ways so that your immune system is on max alert at all times. Sleep enough. Eat well. Exercise regularly. You know the drill.

If you’re already sick, please be responsible and protect others. Keep away from people! If you get symptoms of the flu, stay home! Symptoms are primarily fever, cough, and body aches. You might also have a sore throat, stuffiness or stomach upset. H1N1 typically comes on over a short period of time. Like a Ferrari that goes from zero to 60 in a matter of seconds, H1N1 will rocket you from well to miserable in a matter of hours.

If you are sick, cover your cough. Not with your hands! The latest official advice is to bend your arm at the elbow and cough or sneeze into your elbow, or the fabric of your sleeve above the elbow. If you choose to spray your germs into a tissue, fine, but then please discard the tissue and wash your hands.

The best treatment for H1N1 is rest. Your body is a pretty efficient virus-killing machine, but it needs your support. Stay in bed, drink plenty of fluids, and take medicines for your symptoms. Acetaminophen or ibuprofen for fever and body aches, dextromethorphan for cough, phenylephrine for congestion, or pick your own personal favorite.

If you decide to go to the clinic for H1N1, you’ll probably leave with nothing more than good advice. There are some anti-viral medications on the market, but so far they’re only being used for flu victims that are so sick they need to be in the hospital. Those are the folks with chronic medical problems like asthma, emphysema, diabetes and others. If you have a chronic medical problem and you get sick with flu, you should definitely seek medical care, and you might get treated with antiviral medication. But if you are the typical UNM student, young and healthy, it’s better for you and the rest of the community if you stay home.

UNM is doing its part. We’re expecting an H1N1 vaccine, probably in October, and we’re planning for campus-wide vaccinations. In the next few weeks, watch for announcements about the regular seasonal flu shots, which will be free of charge this year. Meanwhile, you’ll see hand sanitizers around campus, along with signs reminding you to wash your hands. SHAC has provided flu kits to the dorms, with thermometers, surgical masks, hand sanitizer and Tylenol. If you get the flu and you live in the dorms, LaPo will bring you "flu meals." Professors have even agreed to lighten up on asking for doctor’s notes if you have the flu.

Sunday, September 13, 2009

Yesterday I spent the day at a conference for women veterans, designed to provide information and resources for everyone from WWII WACs (and there were two of them there) to Viet Nam Vets to active duty OIF/OEF (Iraq/Afghanistan) personnel, and everyone in between. Not a veteran myself, but with a blossoming interest in a second career in veteran health, I went to learn. Here are some numbers I learned.

New Mexico has 200,000 veterans. Of these 16,000 are women. That's about 8%. Of all the veterans in NM, only about 40,000 have even applied for veterans services and benefits from the state. That means three out of five vets could be getting benefits they aren't getting. At the state level, these range from a free fishing license to scholarships and property tax breaks.

More women are currently in service. Of all American active duty, 15% are now women. The women vets I met and heard yesterday were all very proud of their service and deeply loyal to their country.

The presence of women in the military has brought to light a phenomenon termed MST, or Military Sexual Trauma. This is any kind of sexual harassment or assault experienced while in the military. The Veterans Administration now has a MST coordinator at every facility in the country. Every vet, male and female, who applies for services now gets asked if they experienced MST. They can answer "Yes," "No," or "I don't want to answer." In 2007, 25% of American women vets screened answered Yes.

Of course there was discussion of PTSD, and one speaker reviewed some of the alternate terms being considered for this. There's a move to get rid of the part that says "disorder" so as to reduce any perceived stigma. "Trauma Stress Injury" was my favorite of those mentioned.

There were more numbers, like Chapter 33, which is a GI bill specially for those who serve after 9/10/2001 in OIF/OEF. And 20%, which is how disabled you have to be to receive vocational rehab on the VA's penny. And 22, which is the number of days Shoshana Nyree, the first female American POW of the Iraq war, and our guest of honor, was held before the marines rescued her. (She has a book coming out soon titled Still Standing)

Numbers can be impressive. I know I was impressed with the number of services and benefits available to veterans. I believe they have earned it, and I hope it all helps. And I know that behind the numbers and the statistics are real live women and men, some damaged so badly that no matter what number of services they get they will never heal.

The Authors of "50 Ways" Interview on KCHF TV

50 Ways to Leave Your 40s TV interview with Phoenix' Pat McMahon

About Me

Having been a clinic doc for twenty years, I've reached a point where I want to enrich my life and expand my skill horizons. Hence my creative writing efforts. So far successes include first place in the 2005 SouthWest Writer's Essay contest, co-authorship of a published book called 50 Ways to Leave Your 40s, and a regular health column in the Daily Lobo Newspaper.